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Embryo freezing procedure is a medical technique in which embryos are frozen at a very low temperature of -196 degree Celsius for a pre-determined time period. Embryo freezing is also known as embryo cryopreservation technique. The embryos stored are later used in the Frozen Embryo Transfer (FET) procedure in infertility treatments such as IVF.
In modern times, advanced medical procedures have taken a significant place in treating the medical conditions of patients irrespective of their healthcare issue. Infertility is one of the prime issues for couples who are unable to conceive naturally. Along with treatments created for curing infertility issues, various other medical procedures are introduced which are combined with the chosen treatments to receive the desired results for the patients. In the recent years, the demand for cryopreservation procedure has significantly increased due to increased support of the infertility experts along with government funding which has motivated more number of individuals to go for the embryo freezing procedure. You will be surprised to know that embryo freezing increases the chances of reproduction until 70% when compared to cases which go for natural conception or conventional IVF procedure. This proves to be useful for couples struggling hard to have babies. In countries like Europe, NHS supports In Vitro Fertilization (IVF) cycles of couples to a great extent and helps them receive up to three cycles at affordable and reasonable costs. Europe and North America have recorded the highest growth in the use of IVF treatment, which has proved to be very significant for patients. The usage of eggs, sperms, and embryo freezing in the infertility treatments have also reached to the next level in these continents. In the countries of Asia Pacific, the implementation of infertility treatments has increased significantly because of the fertility tourism and rise in the awareness related to the treatment. In this article, you will find information about different aspects of embryo preservation procedure and its contribution to the success of the IVF procedure. (1)
Embryo Freezing or Embryo Cryopreservation procedure:
Embryo freezing procedure is a medical technique in which embryo formed in the IVF laboratory is stored at a certain temperature. The best temperature at which infertility experts recommend storage of embryo in this technique is around -196 degrees Celsius. This temperature is proven as the most suitable one for preserving embryo in the medical laboratory in the embryo bank or fertility clinic. As per the National Embryo Donation Academy, around 5 lakhs of embryos were stored in embryo cryopreservation procedure in the United States alone. Also, the procedure of embryo cryopreservation is performed within one to six days of the formation of the quality embryo. (2)
History of Embryo Freezing:
Embryo Freezing first came into notice when the first baby was born in the year 1984. The baby born with the assistance of frozen embryo was named Zoe. The scientists of Monash University mentioned that the news of the baby's birth was hidden for 2 weeks to provide desired protection to the baby's family. Professor John Leeton was a significant part of the procedure of In Vitro Fertilization, which helped in the birth of the baby. As per the reports of IVF doctors, it was found that egg and sperm of the couple were fertilized in the medical laboratory. The embryo, which was thus formed, was preserved for a time period of 2 months before progressing with the transfer of the embryo into the uterus of the woman. Fortunately, the embryo got implanted with success. The woman got pregnant and the entire team leading the procedure was happy with the accomplishment. (3) (4)
When is Embryo Freezing procedure recommended?
There are certain specific and crucial conditions in which procedures such as embryo infertility experts recommend the freezing technique. Embryo freezing procedure is advised to patients in the following cases:
- Intentional delay of conception: In recent years, the number of individuals is heading towards a life where professional priorities are considered before building a family. Here, a couple or even a single individual choosing a donor egg or sperm has decided to start a family after a couple of years. In such cases, the embryo-freezing procedure is chosen for the couple. It helps them to store embryo or embryos in the right conditions. As per the recent researches published in the news publications, it is found that Total Fertility Rate (TFR) is decreasing at a constant rate. This has occurred due to the rise in the scenario of delayed marriages and late planning of babies. (1)
- Major health conditions: There are various health conditions, which take a toll on the fertility levels of the body. This makes an individual or couple thinks about safeguarding their eggs, sperms, or embryos for future use to start a family without facing many obstacles in their path towards parenthood. If a couple plans to have a baby, then they can simply take the assistance of the embryos stored in the medical laboratory. Some such health conditions include cancer, which needs to be dealt in a positive manner. Here, embryo cryopreservation will help individuals and couples have babies in the later years of their life as well.
- Will to donate embryo: Most of the couples that go for the embryo freezing procedure are often left with quality embryos. These embryos can be utilized for In Vitro Fertilization treatment of couples who are unable to conceive due to poor quality of embryos formed with their respective sperms or eggs. If a couple has chosen embryo cryopreservation procedure, then they can help other couples going for the embryo donation. Another couple can quickly pick up the embryo donation procedure, thus improving chances of success in the IVF procedure with a positive pregnancy. (5)
How to prepare for Embryo Freezing/ Embryo Cryopreservation procedure?
Patients need to understand that embryo-freezing procedure requires some specific preparation to make sure that the procedure ultimately leads to a successful pregnancy for the couple opting for it. Choosing for the best and proven tips will help couples in preparing for the embryo freezing procedure and receiving the desired results.
- Blood tests are important for screening purpose. This helps in finding out the actual health status of the patients. Ovarian reserve testing is performed to find out the quality and number of eggs. Follicle stimulating hormone (FSH) and estradiol are tested to find out egg quality and number in the concerned women.
- Infectious disease screening is also performed to know whether the woman is affected with HIV, Hepatitis B, and C. This prevents the passage of these serious healthcare conditions into the baby who will be born with the help of the IVF procedure along with frozen embryos.
These tests are common for sperm, eggs, and embryo freezing procedures as well. Before starting with the procedure, couples need to make sure that they go for all the recommended medical tests as suggested by the infertility experts. Time to time monitoring is done under the guidance of the infertility specialists to make sure that the embryo cryopreservation procedure takes place in the right manner. (6)
Methods of Embryo Freezing procedure:
Embryo freezing procedure comprises of different methods, which are utilized as per the requirement of the infertility case of the patients. The most crucial and commonly used embryo freezing procedure includes Slow Programmable Freezing (SPF) popularly known as Slow Freezing along with Vitrification procedure. Each of these methods has its own set of pros and cons which are considered while choosing for the concerned procedure.
1. Slow Programmable Freezing (SPF):
Slow Programmable Freezing (SPF) is one of the top methods, which assist in fertility preservation from several years now. This procedure was utilized for the first time in the year 1986. This procedure was the only reliable way to freeze eggs for nearly 2 decades until procedures like vitrification were introduced. Here, a cryoprotective agent is used to preserve the embryo for a considerable period of time as recommended by the infertility expert himself. The targeted embryo is stored at a temperature of -196 degrees to prevent any kind of damage throughout the time period of embryo cryopreservation procedure. The natural biological processes are shut down naturally in this procedure. Proper care is taken with respect to the cells, as around 30% of the cells in the embryos cannot successfully complete the insemination process, which can also tolerate the thawing procedure. The success rates of the slow freezing or slow programmable freezing (SPF) technique are a considerable one. The slow freezing procedure is possible only in the pronuclear stages. This stage of embryo development is popularly known as PN stage. Therefore, if this procedure is used, then inseminated egg cells are taken for successful completion of the same. This is because the inseminated cells have a different level of sensitivity than the non-sensitive types of cells present in the embryo. The time period, which is involved in the slow programmable freezing procedure, is around hours. This procedure is very less utilized these days. This is because of the increased time consumption. (7)
The procedure of vitrification involves various steps where the specialist utilizes a very high freezing rate when considered on per minute basis. This helps in getting the embryos frozen at a very quick rate. One of the major differences of slow programmable freezing and vitrification is that the later procedure is a modern one and the success rates of vitrification are much higher than the slow freezing procedure. These days, infertility experts highly favor the utilization of vitrification procedure with the help of which embryo freezing can occur quickly without mere wastage of time and energy.
- One of the biggest advantages of vitrification is that it takes much less time to complete the procedure. It is a very rapid medical procedure, which saves a lot of time of the infertility experts and patients as well. Patients need not invest a lot of energy and can stay comfortable with the practice of the vitrification procedure. Here, infertility experts will offer time-to-time guidance and execution of this advanced medical procedure as well.
- The success rates of vitrification procedure are much more than that of slow programmable freezing technique. The success rate of vitrification is 91% when compared to the slow freezing technique, which is, rises till 61%. It is clearly visible that vitrification works better than a slow programmable freezing procedure.
- The prime disadvantage of vitrification is that a very high amount of cryoprotectants is utilized in the procedure of vitrification. The cryoprotectants utilized in the procedure are known to result in cytotoxic effects on embryo.
- In the procedure of vitrification, cells present in the embryo come in direct contact with the liquid nitrogen used in the procedure as well. This can have a negative effect on the overall status of the cells present in the formed embryo. This can also impact on the life of the embryo, which is aimed to be stored in the medical laboratory. (8)
Vitrification is much more favored type of embryo freezing technique these days than slow programmable freezing due to its advantages over the later procedure. Even infertility specialists recommend vitrification to boost success rates of the infertility procedures of couples.
Storage Period of Embryos:
Couples or individuals opting for embryo preservation or cryopreservation procedure need to understand that embryos can be stored for a time period of an average of 10 years. However, this can vary as per the requirement of the couple along with the regulations created in the respective country. You need to understand that some of the countries across the world have set specific regulations about the time frame within which the embryo can be preserved efficiently without affecting its quality. Individuals or couples need to discuss with their infertility expert before going ahead with the cryopreservation procedure. Most of the fertility centres offer different options for the storage of the embryos in terms of the timing of the cryopreservation. (9)
Embryo Freezing procedure in IVF Centres:
Embryo freezing procedure is performed in the IVF laboratory or embryology labs in a fertility center. Some of the best IVF centres across the world offer the top quality embryo freezing services which prove to be beneficial for the couples who are planning for a baby. IVF centres which offer quality healthcare services related to dealing with infertility concerns of couples ensure that couples receive desired success rates with respect to their IVF procedure. This includes storage in the form of frozen embryos and donation to couples. It is also utilized in the medical studies conducted to find out relevant information about human embryos. In cases of any of the types of donation, a proper legal agreement is signed to keep transparency and clarity about the future use of respective embryos. The embryo freezing procedure is performed under the guidance of the infertility experts and embryologists who are specialized in the field of infertility medicine. (10)
Control of patients on Stored Embryos:
The control of patients on embryos, which are stored with the help of embryo cryopreservation, depends on the laws and regulations which revolve around the embryo freezing procedure. You need to provide your informed consent depending on your agreeability on the specified terms and conditions. Some of the crucial aspects about which you need to know the include time duration of the storage of embryos and what would happen if you or your partner has an untimely death. You also need to get clarified that what would happen if you decide not to use those stored embryos and think about embryo donation. Before you go for the embryo cryopreservation procedure, you need to understand if your case requires any further advanced treatments to stay prepared for the future planning of a baby. You will be able to find this out after consulting infertility specialist who is experienced in performing IVF procedure with the help of embryo preservation technique. (11)
Side Effects of Embryo Cryopreservation procedure:
There are certain side effects of embryo preservation, which need to be understood for the proper execution of the treatment. Here are some of the side effects of embryo cryopreservation, which are quite prominently found among patients as well.
Bloating or cramping: This is one of the most commonly occurring side effects, which can be seen in patients who have opted for embryo cryopreservation procedure.
Vaginal Discharge: Vaginal discharge increases in women during embryo preservation procedure. In the case of a severe increase in vaginal discharge, patients need to make sure that they consult an experienced infertility expert without any kind of delay to receive proper medical advice and treatment.
Overstimulation of ovaries: It is often seen that the ovaries get overstimulated during the procedure. Although, this varies from one woman to another depending on the health status of the patient.
Bleeding: Many of the women also suffer from bleeding issues, which need to be dealt in the right manner to prevent further deterioration of the condition.
Feeling full: Patients usually feel like they are completely full which at times creates an imbalance in their body. This can be treated under the guidance of the infertility expert.
Infection: Due to several reasons, infections can be prominently seen in patients who are undergoing the embryo-freezing procedure. Most of the patients suffer from one or more types of side effects associated with embryo freezing procedure, which needs to be tackled in a smart way. An experienced infertility specialist will help couples to a great extent in planning for the embryo freezing procedure. (12)
Embryo Thawing Procedure:
Embryo thawing is a vital procedure in which the embryos stored at a very low temperature are warmed. This assists the stored embryos to reach a stage where they can be utilized in the infertility treatments such as In Vitro Fertilization (IVF) procedure. This helps in transferring embryo in the desired form, which leads to successful implantation in the uterus. The concerned medical specialist makes sure that the embryos formed are warmed at the predetermined temperature, which prepares the embryo for the embryo implantation procedure. (13) (14)
Embryo thawing procedure timing is directly proportional to endometrial receptivity. The thickness of the uterine lining determines the success of the embryo implantation procedure. Prior to the start of the IVF procedure, certain tests are performed for efficient results to make sure that the implantation occurs successfully in the respective patient. Also, the infertility specialist recommends taking certain measures before starting with the IVF treatment. This primarily includes improving diet and lifestyle, which significantly contributes to the improvement of the lining of the uterus. So, you can understand that embryo-thawing procedure is crucial in determining the success of embryo cryopreservation or embryo freezing procedure. (13) (14)
Survival rate post-thawing step:
The post-thawing survival rate is a very important factor in determining the ultimate success of embryo cryopreservation procedure. Patients need to understand that there are several factors, which determine the success rate of embryo freezing procedure. One of the important results of researches was that the post-thawing survival rate was significantly higher in vitrification procedure than that of slow programmable freezing procedure. The vitrified blastocyst success rate was also higher to a certain extent than that the ones who were preserved with the slow freezing procedure. The high survival rate of embryos in vitrification will result in the reduced usage of the embryo thawing procedure for the respective embryos. Based on the expertise of the infertility specialist and case of the patient, it is important to understand that the usage of either vitrification or slow programmable freezing procedure will provide the best results to the patients. One of the studies has also concluded that the babies born with vitrification type of embryo freezing procedure are healthier than those born with a slow freezing procedure. This must be taken into priority while deciding the type of embryo freezing technique. (15)
Fresh vs Frozen Embryo IVF Transfer procedure:
The success rates of fresh and frozen embryo IVF transfer procedure vary based on the complications of the respective procedure. The success rates of fresh and frozen embryo transfer in IVF procedure is a controversial topic as some of the infertility experts favor fresh embryo transfer, while in some cases frozen embryo transfer is a favored one. Fresh embryo IVF transfer procedure requires the use of embryos, which are formed a few days back. This procedure does not require any kind of embryo freezing procedure utilization for achieving a successful pregnancy. Frozen embryo transfer in the IVF treatment includes the usage of frozen embryos. Some of the advantages of frozen embryo IVF transfer procedure include increased pregnancy rates and reduced miscarriage rates. Also, when frozen embryo transfer is chosen in IVF procedure, then there is a lower risk of pre-term labor, increased live births, and healthier babies are born at the end of the pregnancy, which occurred with the IVF procedure. (16)
Thus, embryo freezing or cryopreservation procedure is a very useful and in-demand medical procedure in the field of infertility treatments. Now, it is known to increase success rates of the infertility treatments such as IVF procedure. Such procedures prove to be a blessing for patients who have crossed their reproductive age where they could have conceived naturally. Infertility experts motivate patients to progress with these advanced medical procedures to achieve the best possible success rates.
SOURCES AND REFERENCES:
- ^ In Vitro Fertilization Market - Ein News Einnews.com, 01 May 2019
- ^ Embryo Cryopreservation My.clevelandclinic.org, 01 May 2019
- ^ Embryo Cryopreservation - Wiki Pedia En.wikipedia.org, 01 May 2019
- ^ First Baby Born of Frozen Embryo Nytimes.com, 01 May 2019
- ^ Cryopreservation of Embryos Eggs and Sperm Pamf.org, 01 May 2019
- ^ Egg freezing - Mayo Clinic Mayoclinic.org, 01 May 2019
- ^ Slow Freezing - Fertilitaet Fertilitaet.de, 01 May 2019
- ^ Vitrification at Fertility Associates of Memphis Fertilitymemphis.com, 01 May 2019
- ^ Embryo Cryopreservation - Procedure Details My.clevelandclinic.org, 01 May 2019
- ^ Embryo Freezing - USC Fertility Uscfertility.org, 01 May 2019
- ^ Embryo freezing Hfea.gov.uk, 01 May 2019
- ^ Embryo freezing What you need to know Medicalnewstoday.com, 01 May 2019
- ^ Embryo Thawing - Fertility Smarts Fertilitysmarts.com, 01 May 2019
- ^ Cryopreservation - Egg and Sperm Freezing Uhcw.nhs.uk, 01 May 2019
- ^ Techniques and Instrumentation - Cryopreservation Fertstert.org, 01 May 2019
- ^ Frozen Advantage - About us Ccrmivf.com, 01 May 2019
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